Abstract
The purpose of this paper is to present the development of LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing-sensitive outcomes), a new intervention for loneliness. LISTEN was developed using the Medical Research Council (MRC) framework for intervention development. Extensive literature review revealed that belonging, relating, placing in community, challenges, and meanings of coping were concepts significant to loneliness. Past interventions were limited but it was determined from a recent meta-analysis that enhanced effectiveness might result from interventions that targeted the poorly adapted cognitive processes of loneliness. These processes include social undesirability, stigma, and negative thoughts about self in relation to others. LISTEN is designed to be delivered in a determined logical sequence of 5 sessions, each focusing on the concepts relevant to loneliness as derived from the literature. For each session, intervention delivery is guided by the concepts from story theory (including intentional dialogue, nurse as listener, examination of self in relation to others and community, synthesizing concerns and patterns, and identifying messages) and the principles of cognitive restructuring (self-assessment of maladaptive cognitions, emotions, and behaviors, identifying challenges of changing, reconceptualization of self, new skill acquisition through group interaction, and identifying patterns of meaning in loneliness). LISTEN is developed and the first randomized trial is complete with a sample of 27 lonely, chronically ill, community dwelling, and older adults. LISTEN was evaluated as feasible to deliver by the study team and acceptable for significantly diminishing loneliness by participants of the LISTEN groups who were compared to attention control groups (p < 0.5). LISTEN has the potential to enhance health by diminishing loneliness which could result in improving the long-term negative known sequelae of loneliness. Future longitudinal randomized trials are needed in varied populations to assess long term health and healthcare system benefit of using LISTEN to treat loneliness.
Highlights
Loneliness is a prevalent and significant health problem experienced by over 16% percent of mid-life and older adults in the US [1]
The purpose of this paper is to present LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing sensitive outcomes)
The use of the Medical Research Council (MRC) framework was essential to the successful development of LISTEN
Summary
Loneliness is a prevalent and significant health problem experienced by over 16% percent of mid-life and older adults in the US [1]. Loneliness was identified to be an independent predictor of functional decline [9] and mortality [10] in older adults. It has recently been suggested that loneliness be considered formally as a social determinant of health, even in young populations [12]. This is important because it emphasizes the significance of loneliness as a major contributor to health problem akin to other social determinants like poverty or lack of education. The known contribution of loneliness to negative health outcomes makes it imperative that effective interventions be identified
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